 Jared Hamilton
Brandon Crum is a radiologist in Pikeville.
And Crum says he’s seeing younger miners coming in than before. According to the Center for Disease Control and Prevention, miners are losing more years of their lives to black lung than ever before—dying earlier relative to their life expectancies.
During a recent interview, Crum recounted a case of a man in his thirties who needed a lung transplant, something he says would have been unthinkable a generation ago.
“I ve seen more complicated [black lung] in the last 18 months than I ve seen in my entire career reading black lung X-rays,” Crum said.
Even if coal mining stopped today, Crum says miners and their families will deal with the fallout for decades to come.
“All this complicated disease that we re seeing in 30, 40, 50 and 60 year-olds, somebody s going to have to take care of them for the next 20 or 30 years, and it s going to be a huge burden,” Crum said.
Will new research lead to action?
Coleman knew the fine silica dust he breathed every day had something to do with his condition, but he couldn’t prove it—until now.
Dr. Robert Cohen, a pulmonologist at the University of Illinois at Chicago, recently published a study that compared lung tissue from current miners to tissue from miners in decades past. What he discovered was an irrefutable link between increased silica levels and increased black lung, in younger and younger miners. Cohen says the link is definitive.
“We have a sort of epidemiologic evidence from where the center of the resurgent disease is located in central Appalachia, which is where we see these high silica dust levels,” Cohen said in a recent interview
“I think we have enough evidence to control this.”
An investigation by NPR and Frontline in 2018 found that federal regulators have known about the dangers of silica for at least thirty years, but have taken little action to curb exposure. For decades, despite repeated urging from the National Institute for Occupational Safety and Health, the Department of Labor did not act. After increased scrutiny, the Department of Labor’s Office of the Inspector General released a report affirming the danger of silica dust exposure. Now, Cohen’s research on the surging black lung epidemic is putting pressure on the federal Mine Safety and Health Administration to develop an updated silica standard.
Elsewhere in the federal government, officials have recognized the updated dangers of silica dust. The Occupational Safety and Health Administration brought its exposure limit down from 100 micrograms of silica dust to 50 micrograms in 2014. MSHA’s remains stuck at 100, despite the fact that silica dust exposure in a mining environment is no different from silica dust exposure in any other job.
An X-ray of a black lung patient
That means it’s currently legal for miners to be exposed to twice as much silica dust as workers in any other industry.
But mine safety officials are reviewing the standard, and a rule change could be on the horizon.
In 2019, MSHA issued a request for information on respirable silica, asking for data to support a new standard, or information about technologies available to accurately monitor silica in coal mining operations. In 2020, the Department of Labor’s inspector general notified MSHA that it was not sufficiently protecting coal miners from silica exposure, and recommended immediate action. Former MSHA administrator David Zatezalo responded that the agency did not agree with the recommendations, but would review them.
MSHA officials didn t respond to a request for comment on this story. The agency is expected to issue a new proposed standard, which could appear on the Labor Department s spring rulemaking agenda in the coming weeks. Advocates support any moves the agency makes towards a new standard, but some worry it won’t go far enough.
Will a new silica standard be enough?
Advocates including regional black lung associations and the Appalachian Citizens Law Center petitioned MSHA in 2021 to change the silica standard, saying that in ten years of federal inaction, the black lung epidemic has only gotten worse.
Wes Addington, an attorney who runs the black lung legal clinic at ACLC, says even if a new standard were approved, it could fall short.
“Just because they develop a rule doesn t mean it s going to be sufficient enough to protect future generations of miners from the same fate,” Addington said.
Addington says the new standard could still fail to match OSHA’s, or it might not be paired with increased oversight and improved monitoring. And if the rule is going to work, MSHA needs to look for better ways to monitor silica all the time, not just during inspections, he said.
Addington points out that over the years, MSHA has successfully reduced mining accident deaths, proving that action is possible.
“The risk of immediate mining deaths in coal mines has vastly improved from where it was 100 years ago, or even 50 years ago,” Addington said. “But, the long term exposure to deadly dust has essentially been a failure, especially in the past quarter century.”
But Addington says any change in the standard is better than none.
Meanwhile, the trust fund that miners draw from for benefits is careening into debt — up to $2.8 million per week. The rate of the tax that supports the Black Lung Disability Trust Fund was recently slashed in half. A measure within the massive Build Back Better Act would have boosted the tax, but Democratic U.S. Sen. Joe Manchin of West Virginia, has effectively blocked it from passing.
Advocates fear that as the black lung epidemic expands, more of the burden will fall on miners and taxpayers, rather than on the coal companies that promised to take care of them.
Back at the Cabin Creek Health Clinic in West Virginia, black lung benefits counselor Debbie Wills says she doesn’t understand why coal companies don’t see the benefit of making mines safer to work and breathe in.
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